Foundation for Rural Health Care

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

333275 Issued in MN

Legal business name

FOUNDATION FOR RURAL HEALTH CARE

Doing business as

Evansville Residence

Practice address

651 State St NW
Evansville, MN 56326-8183

Phone

(218) 948-2346

NPI assigned

Sep 5, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Coral Blaze, RN,C RAC-C, CLNC

Title

Ceo

Phone

(952) 435-7371

Specialties & licenses 1

Addresses

Other names 1

• Evansville Residence Doing business as

Tax ID family

Evansville Residence2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Foundation for Rural Health Care

  dba McIntosh Manor

  • Skilled Nursing Facility
  • McIntosh, MN
  • NPI 1871589523
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023110350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 STATE ST NW",
            "city": "EVANSVILLE",
            "state": "MN",
            "postal_code": "563268183",
            "telephone_number": "218-948-2346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 STATE ST NW",
            "city": "EVANSVILLE",
            "state": "MN",
            "postal_code": "563268183",
            "telephone_number": "218-948-2346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNDATION FOR RURAL HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLAZE",
        "authorized_official_first_name": "CORAL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "952-435-7371",
        "authorized_official_credential": "RN,C RAC-C, CLNC"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "333275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evansville Residence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dee Ann Baune
• Evansville Care Campus LLC (Evansville Care Center)
• Evansville Care Campus LLC (Evansville Senior Living)
• Foundation for Rural Health Care (Crestview Manor)
• Kramer Chiropractic P.a.
• Donna K Meissner
• Philicity Kae Messman, LICSW
• Carlie Jo Steffenson

• Assisted Living Facility in Evansville, MN
• Providers in Evansville, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.